Integrating buprenorphine maintenance therapy into federally qualified health centers: Real-world substance abuse treatment outcomes
Drug and Alcohol DependencePublished 17 January 2013Open access
Marwan Haddad, Alexei Zelenev, Frederick L. Altice
Citations77
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Abstract
Integrating BMT in this large FQHC network resulted in retention rates similarly reported in clinical trials and emphasizes the need for providing substance abuse counseling and screening for and treating psychiatric comorbidity.
Keywords
Medicine
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